Wide complex tachycardias: Difference between revisions

	Wide complex tachycardia Microchapters
Home
Patient Information
Overview
Causes
Differentiating VT from SVT with aberrant conduction
Epidemiology and Demographics
Risk Factors
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
EKG Examples
Electrophysiologic testing
Treatment
Medical Therapy
Primary Prevention
Case Studies
Case #1
Wide complex tachycardias On the Web
Most recent articles
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Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Wide complex tachycardias All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Wide complex tachycardias
CDC on Wide complex tachycardias
Wide complex tachycardias in the news
Blogs on Wide complex tachycardias
Directions to Hospitals Treating Wide complex tachycardia
Risk calculators and risk factors for Wide complex tachycardias

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Latest revision as of 21:27, 20 August 2013

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

For patient information, click here

Synonyms and keywords: WCT, fast and wide, wide and fast, wide-complex tachycardia, wide complex rhythm, SVT with aberrancy, SVT with aberrant conduction, supraventricular tachycardia with aberrancy, VT versus SVT, broad complex tachycardia

Overview

Causes

Differentiating VT from SVT as a Cause of Wide Complex Tachycardia

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram

Treatment

Medical Therapy | Primary Prevention

Case Studies

Case #1

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+{| class="infobox" style="float:right;"
+|-
+| [[File:Siren.gif|30px|link=Wide complex tachycardia resident survival guide]]|| <br> || <br>
+| [[Wide complex tachycardia resident survival guide|'''Resident'''<br>'''Survival'''<br>'''Guide''']]
+|}
+{| class="infobox" style="float:right;"
+|-
+| [[File:Physician_Extender_Algorithms.gif|88px|link=Wide complex tachycardia physician extender algorithm]]|| <br> || <br>
+|}
 {{Wide complex tachycardia}}
 {{CMG}}
-{{SK}} WCT; fast and wide; wide and fast; wide-complex tachycardia; wide complex rhythm; SVT with aberrancy; SVT with aberrant conduction; supraventricular tachycardia with aberrancy; VT versus SVT
+'''For patient information, click [[Wide complex tachycardia (patient information)|here]]'''
-== Treatment ==
+{{SK}} WCT, fast and wide, wide and fast, wide-complex tachycardia, wide complex rhythm, SVT with aberrancy, SVT with aberrant conduction, supraventricular tachycardia with aberrancy, VT versus SVT, broad complex tachycardia
-===Defibrillation===
-Indications for defibrillation include the following:
-* [[Chest pain]]
-* [[Congestive heart failure]] ([[CHF]])
-* [[Hypotension]] with symptoms
-* [[Loss of consciousness]]
-* [[Seizure]]
-=== Acute Pharmacotherapies ===
+==[[Wide complex tachycardia overview|Overview]]==
-* '''If stable''':  (More patients than you think)
-* '''DO NOT USE''' Ca2+ Channel blocker, [[Digoxin]] or [[Adenosine]] if you don't not know the etiology of the Wide Complex Tachycardia. Ca2+ Channel blockers and Digoxin can lead to accelerated conduction down a bypass tract and [[VF]].
-* Though ACLS guidelines recommend a diagnostic trial of [[Adenosine]], it can precipitate [[VF]] in some patients with SVT. Patients who have underlying coronary disease may become ischemic from coronary steal. Rhythm can degenerate and lead to [[VF]] that cannot be resuscitated. Furthermore, some [[VT]] (esp those with structurally normal hearts) are [[adenosine]] responsive and can terminate.
-*:# Etiology Uncertain
-*:#:* [[Pronestyl]]  15mg/kg load over 30 minutes then 2-6mg/min gtt
-*:# [[Ventricular Tachycardia]] with active ischemia
-*:#:* [[Lidocaine]] 1 mg/kg q5-10 min up to 3 times then 2-6mg.min gtt
-*:#:* If unsuccessful, [[Pronestyl]] as above
-*:#:* If unsuccessful, IV [[Amiodarone]] 150-300 load over 15-20min.  30-60mg/hr gtt for total of 1gram
-*:# [[Ventricular Tachycardia]] in Setting of [[Cardiomyopathy]]
-*:#:* Skip [[Lidocaine]] and go straight to [[Pronestyl]]
-*:# Positively [[SVT]] with aberrancy
-*:#:* [[Adenosine]] 6mg rapid IV bolus in large vein. May repeat with 12mg x2.
-*:#:* [[Lopressor]] 2.5-5.0mg IV
-*:#:* [[Diltiazem]] 10-20mg bolus followed by gtt 5-20mg/hr
-*:#:* [[Verapamil]] 2.5-5.0mg bolus.
-*:#:* Avoid [[Digoxin]].  Takes too long to work and can be proarrhythmic
-*:#:* [[Pronestyl]] as above
-*:# Antidromic AVRT
-*:#:* If 100% positive [[AF]] is not underlying, can terminate with a nodal blocker
-*:#:* If unsure, [[Pronestyl]] as above
-==Sources==
+==[[Wide complex tachycardia causes|Causes]]==
-Copyleft images obtained courtesy of ECGpedia,  http://en.ecgpedia.org/index.php?title=Special:NewFiles&offset=&limit=500
+==[[Wide complex tachycardia differential diagnosis|Differentiating VT from SVT as a Cause of Wide Complex Tachycardia]]==
+==[[Wide complex tachycardia epidemiology and demographics|Epidemiology and Demographics]]==
+==[[Wide complex tachycardia risk factors|Risk Factors]]==
+==[[Wide complex tachycardia natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
+==Diagnosis==
+[[Wide complex tachycardia history and symptoms|History and Symptoms]] | [[Wide complex tachycardia physical examination|Physical Examination]] | [[Wide complex tachycardia laboratory findings|Laboratory Findings]] | [[Wide complex tachycardia electrocardiogram|Electrocardiogram]]
+==Treatment==
+[[Wide complex tachycardia medical therapy|Medical Therapy]] | [[Wide complex tachycardia primary prevention|Primary Prevention]]
+==Case Studies==
+[[Wide complex tachycardia case study one|Case #1]]
-== References ==
-{{Reflist|2}}
 [[Category:Electrophysiology]]
 [[Category:Cardiology]]
+[[Category:Arrhythmia]]
 [[Category:Emergency medicine]]
 [[Category:Intensive care medicine]]
+[[Category:Arrhythmia]]
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